Risk factors for complications after pancreatic head resection

• Published in: The American journal of surgery Vol. 187; no. 2; pp. 201 - 208
• Main Authors: Adam, Ulrich, Makowiec, Frank, Riediger, Hartwig, Schareck, Wolfgang D, Benz, Stefan, Hopt, Ulrich T
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2004; Elsevier; Elsevier Limited
• Subjects: Abdomen; Adolescent; Adult; Aged; Biological and medical sciences; Chronic Disease; Chronic pancreatitis; Clinical trials; Common Bile Duct Neoplasms - surgery; Complications; Cysts; Female; General aspects; Germany - epidemiology; Hospitals, University - statistics & numerical data; Humans; Male; Medical sciences; Middle Aged; Mortality; Nutrition; Pancreas; Pancreatectomy - adverse effects; Pancreatectomy - statistics & numerical data; Pancreatic cancer; Pancreatic Neoplasms - surgery; Pancreatic surgery; Pancreaticoduodenectomy - adverse effects; Pancreaticoduodenectomy - statistics & numerical data; Pancreatitis - surgery; Parenteral nutrition; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Risk Factors; Rodents; Studies; Survival Analysis; Treatment Outcome; Germany; Pancreatic surgery; Complications; Chronic pancreatitis; Pancreatic cancer; Medicine; Resection; Treatment; Surgery; Risk factor; Complication; Pancreatic head
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2003.11.004

Postoperative morbidity is high after pancreatic head resections. Data about risk factors are controversial. The aim of this study was to evaluate risk factors for complications after pancreatic head resection and to assess whether the complication rate changed during the study period. Data of 301 patients undergoing pancreatic head resection were recorded prospectively. Risk factors were assessed by multivariate analysis. The first and second part of the study period were compared. Mortality was 3%. Overall and surgery-related complications occurred in 42% and 28%, respectively. Independent risk factors for postoperative morbidity were impaired renal function (odds ratio [OR] 2.7), absence of preoperative biliary drainage (OR 1.9), and resection of other organs (OR 3.2). Complication rate, duration of surgery, amount of blood transfused, and length of hospital stay decreased during the study period. Increasing hospital experience decreased complication rates. Patients with risk factors should be considered for transferal to specialized centers.